Comparison of monitoring performance of Bioreactance vs. pulse contour during lung recruitment maneuvers.
Comparison of monitoring performance of Bioreactance vs. pulse contour during lung recruitment maneuvers.
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在肺募集操作过程中，比较生物反应性与脉搏轮廓的监测性能。
DOI：
10.1186/cc7981
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Brusset A
中科院分区：
文献类型：
--
作者：
Squara P;Rotcajg D;Denjean D;Estagnasie P;Brusset A
本研究旨在检验两种器械的心输出量（CO）和每搏输出量（SV）监测能力的等效性假设：无创经胸生物反应（NICOM）和脉搏轮廓分析（PICCO PC）结合经皮热稀释（PICCO TD）。我们纳入了心脏手术后单个ICU的连续患者。在基线、肺复张操作期间（20 cmH 2 O的PEEP）和PEEP停药后，记录并比较了20例患者从NICOM和PICCO PC获得的连续逐分钟血流动力学变量。还测定了PICCO TD测量值。我们使用PICCO TD作为参考，在基线时评估了这两种技术的准确性，并通过平均值周围的波动（2SD/平均值）估计了精密度。然后，我们评估了PEEP应用时检测预期降低的时间响应、幅度响应和可靠性。分析了I型和II型错误。CO值（PICCO TD）范围为1.6 - 8.0 L.min-1。基线时，NICOM、PICCO PC和PICCO TD的CO值相当：5.0 ± 1.2、4.7 ± 1.4和4.6 ± 1.3 L. min。1，分别为（NS）。与PICCO TD的协议限值为1.52 L. min。NICOM为1，最小值为1.77 L- 1个用于PICCO PC，NS。95%的统计功效给出了阈值为0.52 L. min的等效性。1例NICOM与PICCO PC。NICOM和PICCO PC的CO精密度分别为6 ± 3%和6 ± 5%，NS。当应用PEEP时，NICOM、PICCO PC和PICCO TD的CO分别减少33 ± 12%、31 ± 14%和32 ± 13%（NS）。NICOM的时间响应为3.2 ± 0.7分钟，PICCO PC（NS）为2 ± 0.5分钟。SV结果与CO结果相当。虽然仅限于20例患者，但本研究有足够的能力显示出通过经皮热稀释法校准的生物反应性和脉搏轮廓分析的CO和SV监测能力相当。
This study was designed to test the hypothesis of equivalence in cardiac output (CO) and stroke volume (SV) monitoring capabilities of two devices: non invasive transthoracic bioreactance (NICOM), and a pulse contour analysis (PICCO PC) coupled to transpulmonary thermodilution (PICCO TD). We included consecutive patients of a single ICU following cardiac surgery. Continuous minute-by-minute hemodynamic variables obtained from NICOM and PICCO PC were recorded and compared in 20 patients at baseline, during a lung recruitment maneuver (20 cmH2O of PEEP) and following withdrawal of PEEP. PICCO TD measurements were also determined. We evaluated the accuracy of these two technologies at baseline using PICCO TD as reference and we estimated the precision by the fluctuation around the mean value (2SD/mean). Then, we assessed time response, amplitude response and reliability for detecting expected decreases when PEEP was applied. Type I and type II errors were analyzed. CO values (PICCO TD) ranged from 1.6 to 8.0 L.min-1. At baseline, CO values were comparable for NICOM, PICCO PC and PICCO TD: 5.0 ± 1.2, 4.7 ± 1.4 and 4.6 ± 1.3 L.min.-1, respectively (NS). Limits of agreements with PICCO TD were 1.52 L.min.-1 for NICOM and 1.77 L.min.-1 for PICCO PC, NS. The 95% statistical power gives an equivalence with a threshold of 0.52 L.min.-1 for NICOM vs. PICCO PC. The CO precision was 6 ± 3% and 6 ± 5% for NICOM and PICCO PC, respectively, NS. When PEEP was applied, CO was reduced by 33 ± 12%, 31 ± 14% and 32 ± 13%, for NICOM, PICCO PC and PICCO TD, respectively (NS). Time response was 3.2 ± 0.7 minute for NICOM vs. 2 ± 0.5 minute for PICCO PC (NS). SV results were comparable to those for CO. Although limited to 20 patients, this study has enough power to show comparable CO and SV monitoring capabilities of Bioreactance and pulse contour analysis calibrated by transpulmonary thermodilution.
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影响因子：
15.1
作者：
Hofer, Christoph K.;Senn, Alban;Weibel, Luc;Zollinger, Andreas
通讯作者：
Zollinger, Andreas
影响因子：
1.1
作者：
Altman, DG;Bland, JM
通讯作者：
Bland, JM
影响因子：
38.9
作者：
Squara, Pierre;Denjean, Dominique;Dubois, Claude
通讯作者：
Dubois, Claude
影响因子：
9.8
作者：
Biais, M.;Nouette-Gaulain, K.;Sztark, F.
通讯作者：
Sztark, F.
影响因子：
38.9
作者：
Lamia, Bouchra;Ochagavia, Ana;Teboul, Jean-Louis
通讯作者：
Teboul, Jean-Louis